Provider Demographics
NPI:1457569972
Name:LEHAN, DENNIS IVO
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:IVO
Last Name:LEHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 EATON ST
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:IA
Mailing Address - Zip Code:51529-1532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:612 IOWA AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:IA
Practice Address - Zip Code:51529-1334
Practice Address - Country:US
Practice Address - Phone:712-643-5162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist